The coronavirus infection is unmasking diabetes that’s undiagnosed by causing high glucose levels. That’s according to at least two Johannesburg-based specialist doctors dealing with diabetes. They are seeing more patients presenting with diabetes after a coronavirus infection.

They have encouraged people to always test their glucose levels at every health screening, particularly now during the COVID-19 pandemic.

It is estimated that there are 4 million diabetics in South Africa and thousands more are not even aware they have it. High-risk populations include those who are 45 years and older, who have a first-line relative with diabetes as well as those who are overweight and obese.

Doctor Daksha Jivan, an Endocrinologist at Charlotte Maxeke Johannesburg Academic Hospital and Lecturer at Wits University, says those who are undiagnosed but have symptoms such as constant thirst, excessive urine production and blurred vision may be pre-diabetic and should test, particularly, now during the COVID-19 pandemic.

She says this will improve their chance of survival should they be infected with coronavirus.

“Eighty percent of the population will have mild or moderate disease when they contract coronavirus. 20% of patients will have more severe disease. We have a lot of data to show us that patients with diabetes develop more severe disease. So, having a background of diabetes increases your risk of severe disease by two to three times and in-fact your risk of death is even two to three times greater than for the population that does not have diabetes.”

Another doctor, Adri Kok, a specialist physician at Netcare Union and Clinton Hospitals, says they are seeing more diabetic patients admitted to hospital with severe COVID-19 complications.

“The way this virus works is it causes inflammation through the lungs. If a person has high blood sugar, that whole sequence of events is much worse. Part of what we do, of course, is to use cortisone dexamethasone to treat the COVID pneumonia patients that come to hospital. But we’ve just seen significantly more diabetic patients that have come in with COVID to hospital with quite a severe disease.”

Higher number of patients with diabetes

Doctor Jivan says there’s even a higher number of patients who are presenting with diabetes after contracting and battling with coronavirus.

“We are seeing a lot of it in hospitals. Patients may have had diabetes in the background and were never aware of it. This coronavirus infection enters cells and it may enter into the pancreas and damage beta cells that make insulin. The other thing that’s happening is that coronavirus may induce new diabetes. The coronavirus may damage pancreatic cells to a point that you become diabetic. So, it’s very much a vicious cycle coronavirus increases glucose levels. Glucose levels worsen the infection.”

Kok says the coronavirus has a negative effect on the body of a patient with uncontrolled diabetes.

“So, the stress of the disease, the COVID itself, brings out the diabetes. So, it’s almost as if the diabetes was in the background and the COVID is bringing it out and showing us that it’s there. We’ve also seen some Type 1 patients that have presented with what is called a diabetic ketoacidosis, where they then develop this complication because of this high blood sugar that results. So, they would typically present with funny breathing and of course, with COVID you sort of thing … funny breathing is related to the COVID and in this situation, it could be related to the sugar.”

Both Doctors Kok and Jivan encourage people to get tested for diabetes and to maintain their sugar levels to minimise chances of complications and even death from COVID-19.